Dr. Jacobs' goal is to gain the multidisciplinary tools required to become a leader in minority cancer control and prevention research. Building on her strong training in primary care internal medicine and health services research, Dr. Jacobs proposes to develop additional skills through: 1) interaction with a multidisciplinary sponsorship team; 2) tutorials and course work designed to expand her theoretical and methodological horizons; and 3) a focused supervised research program. Her research and career goals involve investigating the importance of trust in physicians and health care institutions to cancer screening behaviors in minority persons. The research proposed in this application examines the relationship between general trust in physicians and health care institutions and breast and cervical cancer screening in African-American women. This project represents the logical next step of Dr. Jacobs research agenda in minority cancer prevention research. She believes that distrust in physicians and health care institutions is an important and unexplored barrier to regular breast and cervical cancer screening in high-risk minority women, especially African- American women. The specific aims of this proposed research are: 1) Development of a measure of general trust in physicians and health care institutions to act in the best interests of patients; 2) Measurement of trust in physicians and health care institutions and its relationship to breast and cervical cancer screening; and 3) To explore the predictors of general trust and physicians and health care institutions. During the final year of funding, Dr Jacobs will seek external funding to further study how trust in physicians and health care institutions might contribute to current models of health belief and health behavior.